Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program

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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
Disability Awareness Program
   Proudly Supported by ...

                               Opening the Door
                                for Children with
                                  Cerebral Palsy

                                 www.grandviewcc.ca
Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
This work is dedicated to the children
                                                             and youth of Grandview Children’s
                                                             Centre who show us the way!

                                                                            Introduction
    About Us
                                                                            When families first find out their child has Cerebral
    Grandview Children’s Centre offers programs and
                                                                            Palsy, they often feel overwhelmed. With information
    services for children with special needs, from infancy
                                                                            scattered in books and on the internet, locating
    to adolescent age. To find out more about these
                                                                            resources to help answer questions can be challenging.
    programs and services and what our staff may be
                                                                            That’s why Grandview Children’s Centre created this
    able to do to help you and your child, please visit                     booklet; to open the door to the world of Cerebral Palsy.
    our website at www.grandviewcc.ca                                       Hopefully it answers some of your questions and sparks
                                                                            more questions for you to ask us. The bolded words can
                                                                            be found in the glossary at the back of this booklet.
    Our Mission
    Grandview Children’s Centre works with children
                                                                            The pictures are of children who attend Grandview
    and youth with special needs and their families to
                                                                            Children’s Centre. They are all learning about
    achieve their personal best.
                                                                            everything they are able to do. The photos say it all -
                                                                            these are happy children. Included in the booklet are

    Our Vision                                                              many comments from parents who write about the
                                                                            impact of having a child with Cerebral Palsy. These
    Grandview Children’s Centre... leading the way to
                                                                            heartfelt words were written for you… read them and
    excellence in services for children and youth with
                                                                            know that you are not alone. Enjoy reading this booklet
    special needs and their families.
                                                                            about the wonderful children of Grandview, and how
                                                                            together, we can help them achieve their personal best.

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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
These heartfelt
words were                                                                        Table of Contents
written for you…
read them and
know that you
are not alone.

                                                                                  6    What is Cerebral Palsy?
                   Acknowledgements
                                                                                  7    How is Cerebral Palsy Diagnosed?
                   Wow… who knew that getting ‘Opening the Door for
                                                                                  8    Are there Different Types of Cerebral Palsy?
                   Children with Cerebral Palsy’ off the ground was going to
                   be so much work. It has been such a great experience for       10   What Causes Cerebral Palsy?
                   Allyson and I to work together. She has brought such a         12   How Does Cerebral Palsy Affect my Child’s
                   thoughtful perspective as she wrote, edited and organized           Learning and Daily Activities?
                   staff participation for this booklet.
                                                                                  14   How Healthy are Children who have Cerebral
                                                                                       Palsy?
                   It is wonderful to see such an insightful and talented young
                   woman make such a great contribution, and for those of         16   Can Cerebral Palsy be Treated? How do we
                   you who are wondering, yes she does have Cerebral Palsy!            Manage Cerebral Palsy?

                   We want to thank Grandview Children’s Foundation for
                                                                                  16   What Types of Therapy will my Child Need?

                   their help organizing the photography and layout, and for      17   Cerebral Palsy and Botulinum Toxin A (Botox®)
                   their generous financial support in making this booklet
                                                                                  18   What’s New in Research?
                   come to life.
                                                                                  20   What Other Programs do
                   Allyson Partridge                Carolyn Hunt                       you Offer?
                   Cerebral Palsy Booklet Project   Developmental Pediatrician
                   Coordinator                      Medical Director,             21   The Doors Open… Now What?
                                                    Grandview Children’s Centre
                                                                                  22   Financial Resources Available for Families of
                                                                                       Children with Disabilities

                                                                                  24   Additional Resources

4                                                                                 26   Glossary                                        5
Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
What is Cerebral Palsy?
What was it like
                                                                                                                                                       How is Cerebral Palsy Diagnosed?
when your child
was first
diagnosed with
Cerebral Palsy?

At first, it was difficult
and hard to accept           What is Cerebral Palsy?                                              How is Cerebral Palsy Diagnosed?
that something was
wrong with my son.           When you have Cerebral Palsy, the part of the brain that controls    Parents are usually the first ones to notice their child has difficulty with motor skills.
Once I came to terms         movement doesn’t work well. There are many causes, but the           For example, your child may not sit up or walk as quickly as other children. They may
with this, all the help      underlying problem is that the signal the brain sends to the         do things slightly differently, such as ‘commando crawl’ (crawl right on their belly) or
and support from the         muscles doesn’t work properly. Commonly, there is difficulty with    walk on their toes. It is also common that your doctor or therapist is the first to notice
Grandview staff made         coordination, balance and tight muscles that make it hard to         differences in motor function. Signs of Cerebral Palsy are present within the first 24
it an easier road.           walk. Most children’s muscles may feel tight or stiff, which is      months of life and it is often suspected as early as 6 months. A firm diagnosis does
                             referred to as spasticity. Some children have only minimal effects   not usually take place until 1 - 2 years of age.
We always knew from          and can walk, while others use a walker or wheelchair. Most
the day our son was          young children with Cerebral Palsy make progress with their          Your doctor is the one who diagnoses Cerebral Palsy. They listen to your child’s
born there was a             motor skills, but the amount of progress and the amount of time      medical and developmental history, especially their motor skills, and review all
problem. We went to          it will take, depends on how severely the child is affected.         aspects of health and development. A physical examination determines whether there
many different doctors                                                                            is tightness in the muscles (spasticity) or increased reflexes. Sometimes pictures of
that had many                                                                                     your child’s brain are necessary to confirm a difference in one of the areas that
different opinions.                                                                               controls motor function and this is called Magnetic Resonance Imaging (MRI). The
So when our son was                                                                               decision to proceed with MRI can be discussed with your doctor and depends on your
diagnosed, we were                                                                                child’s symptoms. Putting all this together, along with information about risk factors
relieved that finally                                                                             and results from tests, allows for a diagnosis of Cerebral Palsy to be made.
there was an answer.

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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
Are there Different Types of                                                                                                                                                                                                  Gross Motor
Cerebral Palsy?                                                                                                                                                                                                               Function
& Determining the Level of Motor Function                                                                                                                                                                                     Classification
                                                                                                                                                                                                                              System Levels

Are there Different Types of Cerebral Palsy?                                                                                                                                                                                  LEVEL 1
Yes. Cerebral Palsy is often classified based on the body part that is                                                                                                                                                        Walks without
affected and the type of movement problem that is present.                                                                                                                                                                    restrictions;
                                                                                                                                                                                                                              limitations in more
                                                                                                                                                                                                                              advanced gross
Spastic Cerebral Palsy                                                        Extra-pyramidal Cerebral Palsy                                            Level of Motor Function (see sidebar)                                 motor skills.
Spastic Cerebral Palsy is the most common type                                Extra-pyramidal Cerebral Palsy is less common and                         At Grandview, we also classify Cerebral Palsy based on how
and means the primary problem is tightness in the                             accounts for about 10% of all children with                               your child’s abilities affect their day-to-day life. This is done     LEVEL 2
muscles. It involves primarily the legs (spastic                              Cerebral Palsy. Children with extra-pyramidal                             using the Gross Motor Function Classification System                  Walks without
diplegia), one side (spastic hemiplegia), 3                                   Cerebral Palsy have extra movements, called                               (GMFCS); a research tool that was developed right here in             assistive devices;
                                                                                                                                                                                                                              limitations walking
affected limbs (triplegia) or the whole body                                  dystonia, or have unsteadiness, called ataxia.                            Ontario. The GMFCS shows us that children with Cerebral               outdoors and in the
(spastic quadriplegia).                                                       Some children have a combination of spasticity                            Palsy have symptoms that cluster in 5 Levels. Children with           community.
                                                                              and extra-pyramidal Cerebral Palsy, which is then                         Level 1 have mild motor symptoms and are able to walk and
                                                                              called mixed Cerebral Palsy. Sometimes children’s                         run. They have differences in speed, quality of movement and          LEVEL 3
                                                                              symptoms don’t fit clearly into one category but the                      agility. Children with Level 5 have the most severe involvement.      Walks with assistive
                                                                              findings on an imaging study, such as MRI, may                            They use a wheelchair for mobility and require help with most         devices; limitations
                                                                                                                                                                                                                              walking outdoors and
                                                                              help clarify the diagnosis.                                               activities of daily living.                                           in the community.

                                                                                                                                                        Research shows that parents are very accurate in determining          LEVEL 4
                                                     Cerebral Palsy                                                                                     the level at which their child is functioning. Talk to your team at   Self-mobility with
                                                    Cerebral = Of the Brain                                                                             the Centre about which level your child is at and what                limitations; children
                                                 Palsy = Lack of Muscle Control                                                                                                                                               are transported or
                                                                                                                                                        expectations to have about your child’s future motor skills. Your
                                                                                                                                                                                                                              use power mobility
                                                                                                                                                        doctor or therapy team is usually able to begin to assess this
                 Spastic                                                                                            Dystonic                                                                                                  outdoors and in the
                                                                                                         Twisting movements / posture of limbs          between your child’s second and third birthday.                       community.
               Hemiplegia
     Affects arm and leg on the same side                           Mixed                                             and trunks
                 Diplegia                         Mixed Cerebral Palsy may have specific features                      Ataxic                                                                                                 LEVEL 5
           Primarily affects both legs                      from both Spastic types and                  Disturbed sense of balance, involuntary
                                                       Extrapyrmidal types of Cerebral Palsy                          movements                                                                                               Self-mobility is
(in some there may be limited arm involvement)
                                                                                                                                                                                                                              extremely limited
                 Triplegia                                                                                              Athetoid
                                                                                                    Difficulty controlling and coordinating movement,                                                                         even with the use of
               3 Limbs involved
                                                                                                                  involuntary movements                                                                                       assistive technology.
              Quadriplegia
           All 4 limbs are involved
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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
What Causes Cerebral Palsy?
                                                                                                                                                  How is Cerebral Palsy Diagnosed?

 What advice
 would you give to
 parents whose               What Causes Cerebral Palsy?
 child has just
                             There are many different causes of Cerebral Palsy. Sometimes
 been diagnosed?
                             doctors can pinpoint why a child has Cerebral Palsy, other times it
                             is very difficult to tell. Cerebral Palsy is caused by injury to the
 Ask, ask, ask questions!    developing brain. This injury affects the parts of the brain that
                             control movement: the motor cortex, the cerebellum and the
 Don't be afraid of the      basal ganglia. This can occur before, during or just after birth.
 diagnosis and take
 advantage of all            One common cause of Cerebral Palsy is prematurity. Infants born
 information offered.        at less than 32 weeks gestational age are more prone to bleeding
 Don't be afraid to ask      in the areas of the brain that control motor function. Bleeding
 questions of any medical    occurs because the blood vessels are not fully developed. If this
 people. Remember you        happens, premature infants will then develop peri-ventricular             Common Causes of Cerebral Palsy
 are in control and you      leukomalacia (PVL) which affects the brain’s motor area. PVL
 will be the best advocate   usually leads to a diagnosis of Cerebral Palsy later on.                  Prenatal (Before Birth)      Perinatal (During Birth)   Postnatal (After Birth)

 for your child.                                                                                       • Congenital Malformations   • Placental Abruption      • Asphyxia
                                                                                                         e.g. Schizencephaly
                             Another common cause of Cerebral Palsy is stroke. Just like adults,
                                                                                                                                    • Hypoxic-Ischemic         • Head Injury
 Breath and research...      children can also have strokes and are particularly vulnerable            • Congenital Infections        Encephalopathy
                             when in utero. No one knows yet how to detect or prevent this,              e.g. Rubella,                                         • Brain Infections
 look for ways you can
                                                                                                         Cytomegalovirus            • Cord Prolapse              e.g. Meningitis,
 assist in your child's      although research is ongoing. Children who have Cerebral Palsy
                                                                                                                                                                 Encephalitis
 progression.                caused by a cerebral artery stroke should have screening blood                                         • Shoulder Dystocia
                                                                                                       • Prematurity /
                             work done to make sure they don’t have any other risk factors for           Low Birth Weight
 Every child is different.   bleeding and stroke.
                                                                                                       • Inflammation of Placenta
 Have faith, your child
 may surprise everyone!      One common misconception is that Cerebral Palsy is caused by a            • Twins / Multiple Births
                             difficult birth. In fact, only a small fraction of Cerebral Palsy is
                             related to specific birth events and in almost all of these cases, even   • Clotting Abnormalities
                                                                                                         e.g. Factor V Leiden
                             the best pre-natal, obstetric and pediatric care could not have
                                                                                                         Deficiency
                             prevented the difficulties or the development of Cerebral Palsy.
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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
How does Cerebral Palsy Affect my
                                                                                             Child’s Learning and Daily Activities?

                      The Term Cerebral Palsy Refers Only                                  Learning Disabilities
                      to Motor Difficulties
                                                                                           There is also a much higher incidence of learning disabilities
                      The term Cerebral Palsy refers only to motor difficulties.           and differences, including attention problems, in children with
                      This includes large movements, such as walking and running           Cerebral Palsy. Sometimes, the injury to the brain affects other
                      (gross motor skills), and can include movements of the hands         areas which control thinking and learning, resulting in an
                      and arms, such as eating and printing (fine motor skills).           intellectual delay or a learning disability.

                      The muscles used for speech and language can also be                 Learning can also be affected because the child has difficulty
                      affected. Speech problems can range from slowed speech, to           interacting with the environment due to their movement
                      difficulty being understood, to not being able to speak at all. If   difficulties. For example, they may not be able to experience
                      the speech and language difficulty is severe, your child may be      the thrill of exploring the ‘pots and pans’ cupboard because
                      able to use an assistive device such as a Picture Exchange           they can not get to it and thus lose out on experimenting with
                      Communication System (PECS) or a specialized computer to             some sounds, places and objects. This is just one reason why
                      help with their communication.                                       it is important to provide stimulating learning experiences and
                                                                                           to bring the environment to them as much as possible.
                                                                                           However, most learning issues relate to underlying changes
                                                                                           and differences in the brain.
 The team at
                                                                                           Sometimes consultation with a Psychologist is recommended to
 Grandview can
                                                                                           complete a formal evaluation of your child’s skills. The team at
 help you                                                                                  Grandview can help you understand your child’s strengths and
 understand your                                                                           challenges and help you plan appropriate goals.

 child’s strengths
 and challenges and
 help you plan
 appropriate goals.

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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
How Healthy are Children
                                                                                                                                                                                              What is the best
    who have Cerebral Palsy?                                                                                                                                                                  thing about having
                                                                                                                                                                                              a child with
                                                                                                                                                                                              Cerebral Palsy?

How Healthy are Children who have Cerebral Palsy?
                                                                                                                                                                                              She is an amazing child;
Most children with Cerebral Palsy are quite healthy. However, there are some                                                                                                                  she makes me laugh
medical issues that are more common in children with Cerebral Palsy.                                                                                                                          everyday.

Bones and Muscles                                                                                                    Vision and Hearing
                                                                                                                                                                                              I think one of the main
If a child has difficulty weight bearing, their bone density can be decreased and calcium and vitamin D              Some children with Cerebral Palsy have differences in the
                                                                                                                                                                                              things is that it put our
supplements may be needed. When a child is not able to walk on their own, tight muscles can pull on their            muscles that control eye movements. This is called strabismus
                                                                                                                                                                                              lives into perspective and
joints, particularly the hips. Very tight muscles can cause the hips to slide (sublux) within the socket. Your       and can cause one eye to ‘turn in’ or give a ‘cross-eyed’
                                                                                                                                                                                              we don't sweat the small
doctor will monitor your child’s hip joints and spine to determine if x-rays are needed. If there are differences    appearance. It is important to treat strabismus as soon as
                                                                                                                                                                                              things. Our daughter is
on the x-ray, or if your child is having pain in their hips, they will be referred to see a Pediatric Orthopedic     possible because glasses, patching and/or surgery may be
Surgeon who run clinics at the Centre. Sometimes other muscles become very tight and surgery can help                helpful to restore the muscle balance and prevent further vision         and always has been
lengthen these muscles.                                                                                              difficulties. A referral to an Ophthalmologist may be required to        such a happy girl with a
                                                                                                                     monitor your child’s progress. A list of Optometrists equipped to        smile that melts your
Feeding, Growth and Nutrition                                                                                        see children with Cerebral Palsy is also available at the Centre.        heart. We have also
When a child’s motor system and movement is severely affected, the muscles that control feeding and                                                                                           learned not to under
                                                                                                                     In Ontario, all children have their hearing screened at birth.
swallowing are also affected. Occasionally a child will have a gastrostomy tube (g-tube) inserted to help                                                                                     estimate her abilities.
                                                                                                                     However, if your child spent a long time in the Neonatal Intensive
with feeding. This is a special tube that goes directly into their stomach and provides either all their nutrition   Care Unit (NICU), been on multiple medications, has had a lot            I didn't think she could
or a ‘top-up’ of calories to help with growth. Your doctor can help you determine if your child is growing           of difficulties with ear infections, or there are concerns about their   do certain things only to
adequately and whether they need more calories to keep up with weight gain. Your child may also be more              hearing, the Centre’s Audiologist can retest their hearing.              be pleasantly surprised.
prone to gastro-esophageal reflux (GERD), constipation, drooling and dental cavities. Usually a
community pediatrician will help you manage these issues.                                                            Sleep                                                                    It teaches me about
                                                                                                                     All small children can have sleep challenges. However, a child           people with special
Seizures
                                                                                                                     with Cerebral Palsy is particularly prone to having them. It is often    needs. I'm more aware
Children with Cerebral Palsy have an increased risk of seizures; however, many kids never have seizures.             harder for parents to let their child ‘cry it out’ as there are so       that we can overlook the
Epilepsy refers to a pattern of repeated seizures. Children with spastic diplegia have a decreased likelihood        many other challenges facing them on any given day. Sometimes            negative and think about
of seizures compared to children with hemiplegia. Children with spastic quadriplegia have the highest                parents worry their child may hurt themselves by crying. All             what people with
incidence. Children with extra-pyramidal Cerebral Palsy may have unusual movements easily confused with              children need a good night’s rest and so do their tired parents!         disabilities can do.
seizures. Some children will need to take medication to help control their seizures and will be followed by          So, if your child is not sleeping through the night by 9 months of
a Neurologist.                                                                                                       age, talk to your doctor.

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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
Can Cerebral Palsy be Treated?
How do we Manage Cerebral Palsy?

Can Cerebral Palsy be Treated?
How do we Manage Cerebral Palsy?

There is no ‘cure’ for Cerebral Palsy. The focus of treatment is on promoting health, wellness and                 Speech and Language Therapy
participation in the community. Children and families may face challenges because of the disability,               Speech-Language Pathologists (SLPs) help children with
but this should not stop them from becoming active members of society. Grandview’s goal is to help                 communication and feeding. They also teach parents ways to
children achieve their personal best through therapy, prevention of secondary problems and                         help their child develop language, speech and other
participation in school and community life.                                                                        communication            skills.    Sometimes    other   methods   of
                                                                                                                   communication will be introduced such as signing, pictures or
                                                                                                                   electronic      devices.           Alternative   and     Augmentative
                                                                                                                   Communication (AAC) is used when communication is very
                                                                                                                   difficult for a child.
                                                                                                                                                                                           What is the
                                                                                                                                                                                           biggest
Physiotherapy                                                                                                      Cerebral Palsy and Botulinum                                            challenge?
Most children with Cerebral Palsy will see a Physiotherapist (PT) to help develop gross motor skills such as       Toxin A (Botox®)
rolling, crawling, standing and walking. Physiotherapists use a variety of methods to help with this including
an active ‘hands on’ approach, and home programs consisting of stretches, exercises and participation in           What is Botox®?
                                                                                                                                                                                           The biggest challenge is
physical activities. Physiotherapy will be based on specific goals identified by you, your child and their         Most children with Cerebral Palsy have stiffness in their muscles       and continues to be
therapist. Specialized equipment may be suggested, such as a walker or stander. Your child may also benefit        referred to as spasticity. When spasticity is severe, sometimes
                                                                                                                                                                                           advocating for our
from using braces such as ankle-foot orthotics (AFOs). There is an Orthotics Clinic at Grandview where             medications can be used to decrease it. Some children may
                                                                                                                                                                                           daughter's needs in all
your child can be fitted with orthotics made especially for them.                                                  benefit from injections of Botulinum Toxin A (also known as
                                                                                                                                                                                           areas of her life. Having
                                                                                                                   Botox®) to help reduce this tightness in their affected muscles.
                                                                                                                                                                                           to have faith and trust in
Occupational Therapy (OT)                                                                                          Botox® temporarily paralyses the spastic muscles so there is less
                                                                                                                   pressure on the joints. The spastic muscles will then grow better       so many people dealing
An Occupational Therapist (OT) will assess your child’s fine motor skills and determine how their fine motor
                                                                                                                   and the other muscles can be strengthened. The decision to use          with your child who is
abilities are impacting their participation in daily activities such as dressing, feeding, bathing, printing and
                                                                                                                          ®
                                                                                                                   Botox is made very carefully and is based on the amount of              unable to verbally
play. Sometimes group therapy will be recommended, other times it will be individual therapy. The OT can
                                                                                                                   spasticity, the child’s medical history, their skills, and input from   communicate has and
also look at your child’s environment and make suggestions about equipment needs like bath chairs, home
                                                                                                                   parent and child. The Centre has a specialized muscle tone clinic       probably always will be
modifications and seating options, such as use of a wheelchair.
                                                                                                                   where children are seen by a Physiatrist who will help you decide       a challenge for me,
                                                                                                                   if Botox® is right for your child.                                      her mum.

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Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
New Programs
    & Alternative Therapies                                                                                  Family Support Workers

                                                       What’s New in Research?                               Here to Help                                                 What barriers
                                                                                                                                                                          exist in society
                                                       There are many exciting areas of research in          Family Support Workers will help you adjust to the news
                                                                                                                                                                          and in the
                                                       Cerebral Palsy. Virtual reality games may be a        that your child has Cerebral Palsy and will provide
                                                       way to improve hand function in children with         opportunities for you to talk with other parents who have    community?
                                                       Cerebral Palsy. Some researchers are looking          children with special needs. They will provide information   How can families
                                                       at how the function of an affected hand               about specialized community supports, resources and
                                                                                                                                                                          overcome this?
                                                       improves if the stronger arm is temporarily           available financial sources. They can also provide access
                                                       constrained. There is ongoing research in the         to individual and family counseling, educational
                                                       dosing and scheduling of Botox® injections            workshops and support groups. Families who have just         We face many physical
                                                       and scientists are also looking at risk factors for   learned their child has Cerebral Palsy have a lot of         barriers in the community
                                                       Cerebral Palsy and ways to prevent injury to          questions, not to mention stressors such as multiple         and accessibility is still
                                                       motor areas of the brain. A lot of research is        medical appointments. Our family support team is skilled     an issue that needs to be
                                                       undertaken at Bloorview Kids Rehab in Toronto         at talking with families, acknowledging their experiences,   an ongoing fight.
                                                       and at Sick Kids. From time to time, Grandview        connecting them with other families and helping them         Families need to get
                                                       becomes involved in research and you may be           cope with all the new information.                           involved and speak to
                                                       asked to participate, if interested.                               Caring for a child with a special need can      local government about
                                                                                                                               be very stressful. There are community     these issues.
                                                                                                                                  resources that can help with respite
Do Alternative Therapies Work?                                                                                                     care. Family Support Services can
                                                                                                                                        help you find what you need.
Many families use alternative and complementary therapies with their
children. We understand you may want to try anything to improve your
child’s health and abilities. However, it is important to carefully look at the
medical evidence for any alternative therapy. We strongly encourage you to
discuss your questions with us first, as some therapies may interfere with
other treatments, such as seizure medication. There are some
complementary therapies that have been shown to be helpful such as
therapeutic horseback riding and hydrotherapy (therapeutic swim time).
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What Other Programs do you Offer?
Educational, Recreational and Leisure Programs

Preschool Programs                                                                                       Recreation and                                 The Door’s Open…
                                                                                                         Leisure Programs                               Now What?
Children with Cerebral Palsy greatly benefit from
a structured preschool environment to enhance                                                            The Centre has fabulous recreation, leisure
                                                                                                                                                        It can often be an overwhelming and
their development. Durham Region has many                                                                and summer day camp programs, which
                                                                                                                                                        stressful time when your child is
excellent childcare programs available that                                                              are made possible by Grandview Children’s
                                                                                                                                                        diagnosed with Cerebral Palsy. As
provide such care. Information about these                                                               Foundation.     Activities   like   swimming
                                                                                                                                                        your child grows and develops, new
programs        can       be       found       at                                                        lessons, creative dance, yoga, martial arts,
                                                                                                                                                        questions are certain to arise. We
www.region.durham.on.ca/childrensservices.                                                               sports night and bowling are also offered.
                                                                                                                                                        encourage you to ask your team at
The Centre’s Preschool Outreach Program                                                                  Some programs are offered at the main
                                                                                                                                                        the Centre a lot of questions. We
(POP) provides consultation to the licensed                                                              site, and some elsewhere in Durham such
                                                                                                                                                        have listed additional resources at
preschools and daycares in Durham. There is                                                              as at Legends Sports Centre, Ajax
                                                                                                                                                        the back of this booklet - visit our
also a daycare for children with special needs                                                           Community Centre, Lakeside Community
                                                                                                                                                        Resource Centre for more
available at Resources for Exceptional Children                                                          School and Sinclair High School. The
                                                                                                                                                        information. In our experience,
and Youth. A subsidy can be applied for through                                                          activities are not only fun, but give
                                                                                                                                                        despite the initial sadness that many
the Children’s Services Division of The Regional                                                         participants a chance to get physical and
Municipality of Durham, although the wait list for
                                                     Campbell Children’s School                          show off their abilities.
                                                                                                                                                        parents feel after a diagnosis of
                                                                                                                                                        Cerebral Palsy is made, most go on
this subsidy can be long. Your family support
                                                     Campbell Children’s School is a small,                                                             to find parenting a child with
team can help you explore these options.                                                                 Programs encourage social interaction with
                                                     specialized school located at the Centre. It is                                                    Cerebral Palsy a very rewarding
                                                                                                         peers and provide the opportunity to
                                                     designed for children with physical disabilities                                                   experience. The children who come
                                                                                                         explore without parents. Programs are
                                                     and/or severe speech needs who require active                                                      to the Centre are wonderful
                                                                                                         changing all the time so keep an eye out for
                                                     therapy. All potential students must be able to                                                    blossoming individuals who will
                                                                                                         the ones that are right for your child. The
                                                     participate in the daily school program, group                                                     achieve AMAZING things! We
                                                                                                         most recent Rec Guide is always available
                                                     activities and therapy sessions. Spots are                                                         welcome you to the Grandview
                                                                                                         at Grandview and on our website at
                                                     available for JK, SK and occasionally Grade                                                        family and are confident that we will
                                                                                                         www.grandviewcc.ca
                                                     One. Short term placements after surgery may                                                       become a positive part of your
                                                     also be available. Spaces are limited, so discuss                                                  family’s life.
                                                     this option with your child’s therapy team.

20                                                                                                                                                                                              21
Financial Resources Available for
Families of Children with Disabilities

Financial Resources Available for
Families of Children with Disabilities
                                                                                                       Jennifer Ashleigh Children’s Charity              Special Services at Home (SSAH)
Here are some of the financial resources available to families of children with disabilities.          This provides financial assistance for children   Helps families purchase respite services or
You will probably need help to navigate ‘the system’, so talk to one of our Family Support Workers,    with disabilities such as treatment needs and     allows them to pay a worker to help their child
they will be happy to help.                                                                            medical expenses.                                 develop skills and participate in activities in the
                                                                                                       905.852.1799                                      community.
Assistance for Children with                                                                           www.jenniferashleighfoundation.ca                 905.665.1030 www.cfcs.gov.on.ca
                                                    Disability Tax Credit (DTC)
Severe Disabilities (ACSD)
                                                    Reduces the amount of tax you have to pay if
Assists with expenses related to your child’s                                                          Ontario Federation for                            Trillium Drug Plan (TDP)
                                                    you qualify. A Disability Tax Credit Certificate
disability and is based on income. If you                                                              Cerebral Palsy (OFCP)                             This helps families who spend a large portion
                                                    T2201, signed by your doctor, needs to be sent
qualify, your child may receive a drug and                                                             This provides some financial support for          of their income on prescription drugs.
                                                    to the Canada Revenue Agency.
dental card.                                                                                           equipment. OFCP also offers a variety of          416.326.1558 or 1.800.575.5386
                                                    1.800.959.8281 www.ccra-adrc.gc.ca
905.665.1030 www.cfcs.gov.on.ca                                                                        programs including educational services and       www.health.gov.on.ca
                                                                                                       individualized planning.
                                                    Easter Seal Society - Durham Region
Assistive Devices Program (ADP)                                                                        416.244.9868 or 1.877.244.9686                    Access 2 Entertainment
                                                    This helps with some equipment costs such as
                                                                                                       www.ofcp.on.ca                                    Depending on your child’s abilities, you may
This covers approximately 75% of the cost of        wheelchairs, orthotics and ramps. Easter Seals
certain equipment (i.e. wheelchair, feeding                                                                                                              be able to purchase an Access 2 Entertainment
                                                    also run summer camps and may provide
pump, ankle-foot-orthotics). Your child’s                                                              Respite Services                                  Card,      which     provides      discounts   for
                                                    financial assistance toward local camp
therapist or dietitian can help you apply.                                                             Helps families with in-home and out-of-home       entertainment activates, such as movies and
                                                    programs. Look on the National Programs
416.327.8804 or 1.800.268.6021                                                                         respite needs and can register you for the        other attractions. www.access2.ca
                                                    page for Access 2 Entertainment Card
www.health.gov.on.ca                                                                                   Community Helpers for Active Participation
                                                    information regarding free admission for
                                                                                                       (CHAP) Program. CHAP helps families find          President’s Choice Children’s Charity
                                                    support persons.
Diaper Grant                                                                                           people interested in working with children with   This charity is dedicated to helping children
                                                    416.421.8146 or 1.866.6303336
Incontinence Supplies Grant                                                                            disabilities. Special Services at Home (SSAH)     who     are    physically   or    developmentally
                                                    www.easterseals.ca www.easterseals.org
                                                                                                       funding can be used to pay a CHAP worker.         challenged, including children with Cerebral
Available from Easter Seal Society for children
                                                                                                       416.322.6317 www.respiteservices.com              Palsy. They are committed to helping remove
over age 3 that use diapers. Your doctor must
sign the application.                                                                                                                                    barriers to independence and may help fund
1.888.377.5437 www.easterseals.org                                                                                                                       mobility      equipment     and    environmental
                                                                                                                                                         modifications.
                                                                                                                                                         www.presidentschoice.ca/Childrenscharity

22                                                                                                                                                                                                       23
Additional Resources

Additional Resources
Please visit our Resource Centre for more information!

Grandview Children’s Centre Disability              Taking Cerebral Palsy to School                     American Academy for Cerebral Palsy and
Awareness Program                                                                                       Developmental Medicine
                                                    Elizabeth Anderson, Valley Park, MO: 2000.
Other resources for school age children and their   JayJo Books, L.C.                                   www.aacpdm.org
classmates 905.728.1673 ext 2560.
                                                    I’m Wendy Blair, Not a Chair!                       Need a family doctor?
Children with Cerebral Palsy                                                                            Try The College of Physicians and Surgeons of
                                                    Carolyn MacDiarmid. 2002. Canadian
A Parents’ Guide - Second Edition                                                                       Ontario’s doctor search. www.cpso.on.ca
                                                    Council on Rehabilitation and Work.
Edited by Elaine Geralis.Woodbine House 1998.       Wendy doesn’t have Cerebral Palsy, she has a
                                                    spinal cord injury, but this is such a great book   Ontario Federation for Cerebral Palsy
                                                    to send to school for the SK to Grade 3 classes     www.ofcp.on.ca
                                                    to read.
                                                                                                        Ontario Paralympics Sports Association
                                                    Grandview Children’s Centre Website                 www.paralympicsontario.ca/ocpsa.shtml
                                                    www.grandviewcc.ca
                                                                                                        Parentbooks.com
                                                    Cerebral Palsy: What Parents and                    A bookstore in Toronto that has great resources
                                                    Doctors Want to Know                                for families of children with special needs.
                                                    Peter Rosenbaum. British Medical Journal,
                                                    Volume 326, pg.970-974, May 3, 2003.                A Comprehensive Guide to Intellectual &
                                                                                                        Developmental Disabilities
                                                    CanChild Centre for Childhood                       Brown & Percy 2007.
                                                    Disability Research                                 Chapter on Cerebral Palsy written by
                                                    www.canchild.ca                                     Drs. Hunt & Fehlings.

24                                                                                                                                                        25
Glossary
Alternative Therapy                                  Constipation                                       Gastro-Esophageal Reflux Disease (GERD)            Picture Exchange Communication
Therapy that is outside the scope of traditional     A child is not having regular, soft bowel          Liquid and/or food that is in the stomach and      System (PECS)
medical practice.                                    movements. Frequency of normal bowel               moves back up to into the esophagus. Many          A series of cards, which can be used in place of
                                                     movements can vary from child to child but         young children experience this, but when a         spoken language, to request items and activities.
Ankle-Foot-Orthotic (AFO)
                                                     most typically developing children will have       child has Cerebral Palsy and their muscles         Physiotherapist (PT)
A plastic brace that is molded to the shape of
                                                     at least one bowel movement per day.               don’t function normally, the reflux can be         A professional trained           to   help    achieve
your child’s foot. It helps maintain a stretch on
                                                                                                        severe. Some symptoms include pain,                maximum mobility.
tight muscles and a normal foot position.            Developmental Pediatrician
                                                                                                        irritability and vomiting.
                                                     A Pediatrician who has completed specialized                                                          Prematurity
Ataxia
                                                     training in child development. They will collect   Gross Motor Function Classification                Infants who are born before 37 weeks gestational
A disorder of movement that results in
                                                     detailed information and do a physical             System (GMFCS)                                     age.
instability while walking.
                                                     examination to make a diagnosis. Sometimes         Describes the severity of Cerebral Palsy.
Audiologist                                          they will complete additional tests to assess                                                         Psychologist
                                                                                                        Gross Motor Skills                                 A professional trained in assessing thinking
A professional who assesses hearing.                 specific aspects of development.
                                                                                                        Large movements such as rolling, sitting,          or cognitive skills.
Basal Ganglia                                        Diplegia                                           crawling, standing and walking.
Specialized structures in the brain that help        When primarily the legs are affected.                                                                 Quadriplegia
                                                                                                        Gastrostomy Tube (G-Tube)                          When both arms and both legs are affected.
control movement.
                                                     Dystonia                                           A tube inserted by a surgeon or radiologist into
Botulinum Toxin A (Botox®)                           Muscles that have variability in tone. Children    the stomach by making a small incision in the      Seizure
Medication used to treat muscle tightness. It is     usually have some uncontrolled movements.          skin and stomach lining. It is used for children   An electrical discharge in the brain that causes the
derived from a toxin produced by a bacteria that                                                        who are unable to manage pureed food or            nerve cells to fire too quickly resulting in a loss of
                                                     Epilepsy                                                                                              consciousness and shaking of the arms and legs.
causes temporary muscle weakness.                                                                       who are having trouble taking in enough
                                                     A condition where an individual has seizures                                                          Sometimes seizures are subtle and will result in
                                                                                                        calories to maintain their weight.
Cerebellum                                           regularly.                                                                                            loss of control of only certain muscles, staring
A structure at the back of the brain that is often                                                      Hemiplegia                                         spells or changes in heart rate.
                                                     Extra-Pyramidal Cerebral Palsy
considered to be the “control centre”                                                                   When one side of the body is affected.
                                                     Cerebral Palsy that is predominately a                                                                Spasticity
for movement.
                                                     movement disorder as opposed to spasticity.        Magnetic Resonance Imaging (MRI)                   ‘Tightness’ in the muscles.
Cerebral Artery Stroke                                                                                  A large magnetic tube machine. The child goes
                                                     Family Support Worker                                                                                 Speech-Language Pathologist (SLP)
A blockage or bleed of one of the main blood                                                            inside the tube and the magnetic forces in their
                                                     A social work professional with a broad range                                                         A professional trained to assist in verbal or
vessels of the brain.                                                                                   brain are measured and turned into a picture.
                                                     of skills who can help you and your family cope                                                       non-verbal (pictures, computers, signs) speech
Commando Crawl                                       with the challenges of having a child with a       Motor Cortex                                       production and language skills.
When a child moves on their stomach by               disability and provide links to financial and      The area in the brain that controls basic motor
pulling along with their arms, without much          community programs.                                function.                                          Strabismus
movement in the legs. (i.e. an army                                                                                                                        A visual disorder where the eyes are misaligned
                                                     Fine Motor Skills                                  Occupational Therapist (OT)                        and point in different directions.
commando crawling under a wire.)
                                                     Movements of the hand and arm, such as             A professional trained to help achieve maximum
Complementary Therapy                                eating, dressing and printing.                     functional independence and often focuses on       Sublux
Used in conjunction with traditional medical                                                            hand function and equipment needs.                 Gradual movement of the head of the femur bone
therapy. It may include such things as                                                                                                                     (top of the leg) within the hip socket. When a child has
                                                                                                        Periventricular Leukomalacia (PVL)                 very tight muscles and is not weight bearing, this
therapeutic horseback riding or sensory
                                                                                                        Injury to the white matter surrounding the         movement can change the forces at work on the hip,
integration therapy.
                                                                                                        ventricles (spaces) in the brain.                  causing the hip to gradually move out.
26                                                                                                                                                                                                           27
600 Townline Road South, Oshawa, Ontario L1H 7K6
      Tel: 905.728.1673 or 1.800.304.6180
               Fax: 905.728.2961
               Email: info@grtc.ca

        www.grandviewcc.ca
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